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Introduction
a
Department of Surgery, Princess Margaret Hospital for Children, Perth,
Western Australia, Australia
b
Corresponding author: Bhanu Mariyappa, Department of Paediatric
Surgery, Princess Margaret Hospital, Perth, Western Australia, Australia.
Email: tvkbhanu@yahoo.com
76 Articles © The authors | Journal compilation © World J Nephrol Urol and Elmer Press Inc™ | www.wjnu.elmerpress.com
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Mariyappa et al World J Nephrol Urol • 2013;2(2):76-78
Discussion
Articles © The authors | Journal compilation © World J Nephrol Urol and Elmer Press Inc™ | www.wjnu.elmerpress.com 77
Wilms’ Tumor World J Nephrol Urol • 2013;2(2):76-78
base [1]. The prognosis of these children with complete resection re-
Mere extension of the tumor into the ureter or bladder mains good. There is no need for routine cystoscopic surveil-
without actual invasion of the wall does not upstage the tu- lance to monitor for intravesical recurrence, as there has not
mor [3]. It is important to be aware of this so that overstaging been a reported case with intravesical recurrence.
of the tumor and associated morbidity of the adjuvant treat-
ment can be avoided. Johnson et al have suggested the need
for cystoscopic surveillance post operatively to detect tumor References
recurrence [5]; however, NWTSG database analysis does not
support such a recommendation because local recurrence af- 1. Ritchey M, Daley S, Shamberger RC, Ehrlich P, Hamil-
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tumor: a report from the National Wilms’ Tumor Study
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1629.
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for 2% of cases, with bladder extension seen in even fewer Wilms tumor. J Urol. 1976;115(4):467-468.
cases. Ureteral and bladder extension should be suspected 3. Mitchell CS, Yeo TA. Noninvasive botryoid exten-
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considered. Recognition of ureteral and bladder involvement 5. Johnson F, Luttenton C, Limbert D. Extrarenal and uro-
is important to carry out complete resection without spillage. thelial Wilms tumor. Urology. 1980;15(4):370-373.
78 Articles © The authors | Journal compilation © World J Nephrol Urol and Elmer Press Inc™ | www.wjnu.elmerpress.com